Anastomosis procedures are required for connecting or re-connecting body tissue, e.g., as part of a surgical procedure. The tissue may be part of a body lumen such as a blood vessel, intestinal or other digestive system tissue, or tissue relating to the urinary system. As one example, in a radical prostatectomy, a surgeon removes all or most of a patient's prostate. Because the urethra travels through the prostate immediately before reaching the bladder, the upper part of the urethra is also removed with the surgery. The procedure leaves a severed urethral stump and a severed bladder neck. To restore proper urinary functions, the bladder and the urethra must be reconnected.
Conventionally, a surgeon may execute delicate suturing operations with tiny, fine needles to reconnect these or other anatomical bodies. However, installation of sutures with a needle to connect severed tissues can be a difficult and technique-sensitive task. Many factors can make the task difficult, including a very small amount of tissue to work with (e.g., at the urethral stump and at the bladder neck), and proximal sensitive tissues such as ureters at a bladder and a proximal nerve bundle and sphincter at a urethral stump. These factors result in complicated and delicate suturing procedures that, if not performed properly, could result in complications such as leakage, difficulty in healing or failure to heal, or specific conditions such as incontinence or impotence. Specific problems that can occur include necrosis of the sutured tissues; stricture of the urethra, which impedes the flow of fluid through the urethra; and a urethra-bladder connection that is not fluid-tight. In addition, methods of suturing the urethra to the bladder allow for the possibility of accidental or inadvertent piercing of the nearby neurovascular bundle, which can cause incontinence or impotence.
To reduce the risks involved in conventional suturing procedures, anastomosis devices have been developed that include features that allow for reconnection of tissues without using traditional sutures. These anastomosis devices eliminate the need for sutures to reconnect severed tissue during anastomosis procedures, which can both reduce the risks during the surgical procedure and also provide a significant reduction in the amount of time required to perform certain anastomosis procedures. When an anastomosis device of this type is surgically positioned with the tissue approximating structure inside the patient, its actuating mechanism can be attached to the device and located outside the patient's body, where the surgeon or doctor can manipulate it via some type of control device or mechanism, as desired. In some cases, this configuration of the actuating mechanism may also allow for inadvertent or purposeful manipulation of the externally located components by the patient after the surgeon properly positions the device and actuates the tissue approximating structures. Any such manipulation of the actuating mechanism can be somewhat undesirable for the recovery of the patient, such as if a patient were to retract the tines before the reconnection of tissues within the body has taken place. In this case, the tissues may not heal completely, which can cause a variety of physical issues for the patient, such as leakage of bodily fluids in the area where a urethra-bladder connection is not fluid-tight. Thus, it may be desirable in some cases to prevent or limit intentional and unintentional manipulation of the actuating mechanism for the external actuating mechanisms and associated componentry of an anastomosis device.